Training Module Natomas Unified School District

*MEDICATION ADMINISTRATION

*Course OVERVIEWPolicies and Procedures

Importance of proper medication administration

Types of medications administered in a school setting

The 6 Rights of proper medication administration

Standard Precautions related to the administration of medication

Forms Required for medication administration in school setting

*Objectives

*Participants completing this program will

be able to:

Understand the importance of proper

medication administration

Identify the requirements for proper

medication administration

Recognize and apply the six (6) rights of

medication administration

*Objectives

Understand appropriate and correct

documentation of medication administration

Use standard precautions during the

administration of medication

Understand medical confidentiality as it

relates to medication administration

Identify proper storage of prescription and

over-the-counter medication

*Goal

The goal of this program is to provide

school staff with information about the

student’s right to receive medication at

school and responsibilities of the

prescriber, school district, and school

staff.

* Importance of Proper Medication Administration

More chronically ill and stable children are going to school with medications required to be taken some time while in school

Proper administration of medications can promote and support a child’s academic success

Proper administration of medications may help keep a child healthy and keep his or her chronic condition stable

*Requirements for medication administration

*What is needed?

The requirements for administering

medication in school are the same

regardless of the type of medication(over-

the-counter or prescribed).

Parents/guardians must provide:

Written statement (doctor orders) from authorized health care provider licensed in the State of California to prescribe medication

Written statement expressing their intent for the school to administer the medication

*Requirements for medication administration

Each medication –prescription or over-the counter will be counted by designated school staff and parent/guardian:

Each time a medication is brought to schoolChange in medication (return old prescription meds)

The amount of pills, tablets, liquid…etc. will be documented on the Medication Count Log

Inhalers and Epi-Pens will be counted and documented on the Medication Count Log

*STORAGE OF MEDICATION

All medication will be stored according to the manufactures instructions.

Each school site will have a designated, locked cabinet in the Health Office that is accessible to authorized staff.

The locked area will be kept clean and dry for the storage of medication.

Each student’s medications should be kept in a plastic container labeled with their name. The container should be locked in the medication cabinet.

*Who is an authorized health care provider?

California-licensed physician and surgeon

California-licensed dentist

California-licensed nurse practitioner and California-certified nurse midwives

California-licensed physician assistants

*What is needed from the parent/guardian?

*Request to Administer Medication at

School from the parent/guardian contain

the following:

Consent for authorized school staff to

administer the medications

Agreement that the parent/guardian will

provide the necessary medication,

supplies, and equipment

*Continued

Agreement that the parent/guardian

will notify authorized school staff if

there is a change in student’s

medication, health status or

authorized health care provider

Sign the Medication Count Log each

time a medication is brought to school

*When is a new written statement required?

Changes in medication, dose, time, and

method of administration

Change in California authorized health

care provider

Discontinuance of medication

Annually

*What information must the Authorized health provider’s written statement contain?

Student’s name and date of birth

Name of the medication and reason for

administration

Amount or dose of the medication

If pill splitting is authorized, only scored pills

may be split in half

Method of administration

*Continued

Time of administration at school

Possible side effects

PRN (as needed) order must contain

specific symptoms that require the

administration of the medication

Frequency of administration (every 4 hours)

Indications for referral for medical

evaluation

*What is needed for student-self administration ?

Statement from authorized health care provider that the student is competent to safely self-administer the medication

Name, address, telephone number, and signature of California authorized health care provider and stamp

Parent/guardian authorization

*Missing or illegible information

Do not guess:

Do not administer the

medication

Notify the District nurse

immediately

*Written Request to Administer medication

Acceptable written statement from authorized health care provider:Physician’s order hand written or printed from private office or health care clinic

OR

NUSD printed forms:Physician Request to Administer Medication at School used for medications/treatments other than Seizures, Diabetes, Allergies and Asthma

*Written Request to administer Medication

*Use the following for specific health conditions:

Asthma Management for the School SettingDiabetic Medical Management PlanSeizure Action Plan for the School SettingSevere Allergies Action Plan for the School Setting

*Written Request to Administer Medication

Parent/Guardian

*Use this form all medication requests:

Request to Administer Medication at School – Parent/Guardian

Short Term

Antibiotics Over-the counter medications

EMERGENCYEpi-PensGlucagonQuick-relief inhalers

Long TermAnticonvulsantsInsulinPsychotherapeutic Agents: antidepressants, and antipsychotic

Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD)

*Types of Medications Present In a School setting

*Medications maybe administered in many

different waysOral (by mouth) tablets come in different forms: regular chewable, sublingual and scored

Topical – drops, ointments, and creamsInhaler and Nebulizers –deliver a fine mist

RectalInjection

*It is important to administer medications as

prescribed Tablets unless otherwise ordered should be taken with at least 4 to 6 ounces of a liquid.

Scored tablets maybe cut into smaller pieces once

Enteric coated tablets should not be split or crushed

The coating dissolves in the intestine to prevent stomach irritation

*It is important to administer medications as

prescribedChewable tables should be chewed before swallowing

Capsules are coated to dissolve in the stomach or intestine over a period of time

Swallow whole unless otherwise prescribed – do not break apart

*Continued

Oral medication should not be crushed without a licensed health care provider’s order (Doctor’s order)

Be sure the student swallows the medication

*Safe Medication Administration

*Hand washingWash hands before and after giving medication/treatments

 Disposable gloves If contact with blood or bodily fluids is expected

Wash hands before and after putting gloves on

Dispose of gloves and other materials properly

*Do not administer if:Unlabeled medication

Medication with incomplete instructions

Medication belonging to another student

Expired or discolored medication

If all six right have not been checked first

DO NOT - Return unused medication to

prescription bottle

*Six Rights of Administering Medications1.Right Person: Ask student for name,

compare face to picture on container

2.Right Medication: Pharmacy label on medication bottle/container matches the Request to Administer Medication (physician orders) and the Medication Log

3.Right Dose: Compare the Medication Log with Pharmacy label and Request to Administer Medication (physician orders)

*Six Rights Continued

4. Right Time: Medication is give at the correct time – compare the Medication Administration Log, Pharmacy label, and The Request to Administer Medication (physician orders)

5. Right Route: Correct route is used – compare the Medication Administration Log, the Pharmacy label, and The Request to Administer Medication (physician orders)

6. Right Documentation: After the administration of the medication to the student: Document the name of medication, date, time, dose, and your initials on the student’s Medication Log

*Expired medications

Document the expiration date on the Medication Log

Check the expiration date of each medication prior to

administration

Do not administer expired medication

Notify parent to pick up expired medication

Do not place expired medication in the trash or toilet

*Medication Error

*A medication error occurs when a medication is not administered as prescribed

Examples of medication errors:Omission

administration of a medication to wrong student

wrong dosage

Medication Error Continued

wrong time

wrong route

crushing a medication that shouldn’t be crushed

documentation errors – omission, wrong student

*Steps to avoid a medication ErrorPrepare medication for one student at a time

Give the medication to the student as soon as you remove it from container

Do not talk to others and ask them not to talk to you when you are giving medication

Do not stop to do something else in the middle of giving medication

Pay close attention at all times when you are giving medications

*Steps to Avoid a Medication ErrorAlways compare the student’s name to

the:

Pharmacy label

Request to Administer Medication (health care provider’s orders)

Medication Log

*Steps to Avoid a Medication Error

*Make sure all three forms match:

If they do not match, or if there is any doubt about whether you are giving the right medication to the right individual

STOP! Do not give the medication

Ask questions!!

*If you make a mistakeDo not send student to class, keep in Health Office and monitor for side effects of the medication

Follow the District’s Policy for reporting medication errors (AR 5141.21 (e))

Notify the site administrator

Notify the parent

Notify site District Nurse

Monitor the student for side effects

Complete Incident Report

*DOCUMENTATION

*Each medication is documented when administered on the student’s Medication Log

School staff will document the:Time, DateDose, RouteInitials of person administering medication

*Additional documentation:

Student refuses to take medication

Student is absent from school

Field trip

Wasted medication – pill dropped

*FIELDTRIP

A student may not be prevented from going on a field trip due to medication administration

Arrangements for the administration of medication will be a coordinated effort with the parent by the site administrator, authorized school staff and the district nurse

Request for Medication Administration forms must be completed for all fieldtrips over-night as well as day trips.

*CONFIDENTIALITY AND PRIVACY

*The Family educational Rights and Privacy Act (FERPA) is a federal law that protects the privacy of students and their educational records.

Health records maintained by school employees for Pre-Kindergarten through grade 12 are protected by FERPA

Information should be shared on a “need to know” basis

Resources

*National Association of School Nurses8484 Georgia Ave #420Silver Spring, MD 20910240-821-1130nasn@nasn.orghttp://www.nasn.org/

*American Academy of Pediatrics141 Northwest Point Blvd.Elk Grove Village, IL 60007(847) 434-4000http://www.healthychildcare.org/index.html

*California Department of Education1430 N StreetSacramento, CA  95814http://www.cde.ca.gov/Is/he/hn/medication.asp